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European Heart Journal. Acute Cardiovascular Care

Maximilian Tscharre, Christina Hauser, Miklos Rohla, Matthias K Freynhofer, Johann Wojta, Kurt Huber, Thomas W Weiss
AIMS: We investigated the association between epicardial adipose tissue (EAT) thickness and cardiovascular outcomes in a cohort of high-risk patients with acute coronary syndrome undergoing percutaneous coronary intervention. METHODS: Of 1198 patients undergoing percutaneous coronary intervention, transthoracic echocardiography was performed in 438 patients during the index hospitalization. EAT thickness was measured in the parasternal long-axis view perpendicularly on the free wall of the right ventricle at end-systole in three consecutive cardiac cycles and then averaged...
November 18, 2016: European Heart Journal. Acute Cardiovascular Care
François Schiele, Michel Farnier, Michel Krempf, Eric Bruckert, Jean Ferrières
In patients admitted for acute coronary syndrome (ACS), the guidelines of the European Society of Cardiology give a Class I, Level A recommendation for the prescription of high-intensity statins to be initiated as early as possible, regardless of the low-density lipoprotein cholesterol (LDL-C) level. Although statins are widely prescribed after ACS, the intensity of therapy and the proportion of patients achieving target LDL-C values are often not in line with recommendations due to a lack of compliance with guidelines by the physicians, a lack of compliance with treatment or poor tolerance by patients, and poor dose adaptation...
November 17, 2016: European Heart Journal. Acute Cardiovascular Care
Akram Y Elgendy, Islam Y Elgendy, Hend Mansoor, Ahmed N Mahmoud
BACKGROUND: Evidence remains inconsistent regarding the incidence and prognosis of Takotsubo syndrome in the setting of subarachnoid hemorrhage. Thus, we aimed to evaluate the clinical presentation and in-hospital mortality of these patients. METHODS: A systematic review of the electronic databases was conducted for studies involving patients with spontaneous subarachnoid hemorrhage and concomitant findings of classical Takotsubo syndrome on transthoracic echocardiogram...
November 16, 2016: European Heart Journal. Acute Cardiovascular Care
Christel Ga Nielsen, Kristina G Laut, Lisette O Jensen, Jan Ravkilde, Christian J Terkelsen, Steen D Kristensen
BACKGROUND AND AIMS: To improve treatment success of ST-elevation myocardial infarction, a minimal delay from symptom onset to reperfusion therapy is crucial. The patient's response to initial symptoms (patient delay) substantially affects the delay. We investigated time patterns of patient delay during a seven-year time period, and aimed to identify key predictors that affect the length of the patient delay. METHODS: Data on 5848 patients hospitalized with ST-elevation myocardial infarction and treated with primary percutaneous intervention during the period 2003-2009 were obtained from Danish registry databases...
November 7, 2016: European Heart Journal. Acute Cardiovascular Care
Stéphane Boulé, Nicolas Détis, Nicolas Lamblin
We report the case of a 64-year-old woman who was admitted for cardiogenic shock caused by a permanent junctional reciprocating tachycardia. If this incessant and drug-refractory form of tachycardia is a well-known cause of tachycardia-induced cardiomyopathies in infants, its occurrence during adulthood is extremely rare. Catheter ablation is the recommended treatment of this condition.
October 24, 2016: European Heart Journal. Acute Cardiovascular Care
Alban-Elouen Baruteau, Thomas Barnetche, Luc Morin, Zakaria Jalal, Nicholas S Boscamp, Emmanuel Le Bret, Jean-Benoit Thambo, Julie A Vincent, Alain Fraisse, Alejandro J Torres
BACKGROUND: Transcatheter techniques are emerging for left atrial (LA) decompression under venoarterial extracorporeal membrane oxygenation (VA-ECMO). We aimed to assess whether balloon atrioseptostomy (BAS) is a safe and efficient strategy. METHODS: All patients who underwent percutaneous static BAS under VA-ECMO at four tertiary institutions were retrospectively reviewed. RESULTS: From 2000 to 2014, BAS was performed in 64 patients (32 adults and 32 children)...
October 14, 2016: European Heart Journal. Acute Cardiovascular Care
Alfonso Jurado-Román, Pilar Agudo-Quílez, Belén Rubio-Alonso, Javier Molina, Belén Díaz, Julio García-Tejada, Roberto Martín, Rocío Tello
BACKGROUND: There are few data on the prognostic significance of the wall motion score index compared with left ventricle ejection fraction after an acute myocardial infarction. Our objective was to compare them after the hyperacute phase. METHODS: Transthoracic echocardiograms were performed in 352 consecutive patients with myocardial infarction, after the first 48 hours of admission and before hospital discharge (median 56.3 hours (48.2-83.1)). We evaluated the ability of the wall motion score index and left ventricular ejection fraction to predict the combined endpoint (mortality and rehospitalization for heart failure) as a primary objective and the independent events of the combined endpoint as a secondary objective...
October 13, 2016: European Heart Journal. Acute Cardiovascular Care
Federico Guerra, Lorena Scappini, Alessandro Maolo, Gianluca Campo, Rita Pavasini, Matilda Shkoza, Alessandro Capucci
BACKGROUND: Stroke is a rare but serious complication of acute coronary syndrome. At present, no specific score exists to identify patients at higher risk. The aim of the present study is to test whether each clinical variable included in the CHA2DS2-VASc score retains its predictive value in patients with recent acute coronary syndrome, irrespective of atrial fibrillation. METHODS: The meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines...
October 5, 2016: European Heart Journal. Acute Cardiovascular Care
Tetsuma Kawaji, Hiroki Shiomi, Takeshi Morimoto, Yutaka Furukawa, Yoshihisa Nakagawa, Kazushige Kadota, Kenji Ando, Tetsu Mizoguchi, Mitsuru Abe, Mamoru Takahashi, Takeshi Kimura
BACKGROUND: Cardiogenic shock remained the leading cause of death in ST-segment elevation acute myocardial infarction (STEMI) patients even in the primary percutaneous coronary intervention era. METHODS: Among 3942 STEMI patients with primary percutaneous coronary intervention within 24 h after symptom-onset in the Coronary Revascularization Demonstrating Outcome Study in Kyoto acute myocardial infarction registry, the study population of the current analysis consisted of 466 STEMI patients who were complicated by cardiogenic shock due to acute pump failure...
October 5, 2016: European Heart Journal. Acute Cardiovascular Care
Magnus T Jensen, Marta Pereira, Carla Araujo, Anti Malmivaara, Jean Ferrieres, Irene R Degano, Inge Kirchberger, Dimitrios Farmakis, Pascal Garel, Marina Torre, Jaume Marrugat, Ana Azevedo
AIMS: The purpose of this study was to investigate the relationship between heart rate at admission and in-hospital mortality in patients with ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation acute coronary syndrome (NSTE-ACS). METHODS: Consecutive ACS patients admitted in 2008-2010 across 58 hospitals in six participant countries of the European Hospital Benchmarking by Outcomes in ACS Processes (EURHOBOP) project (Finland, France, Germany, Greece, Portugal and Spain)...
September 30, 2016: European Heart Journal. Acute Cardiovascular Care
Patrick Sulzgruber, Fritz Sterz, Michael Poppe, Andreas Schober, Elisabeth Lobmeyr, Philip Datler, Markus Keferböck, Sebastian Zeiner, Alexander Nürnberger, Pia Hubner, Peter Stratil, Christian Wallmueller, Christoph Weiser, Alexandra-Maria Warenits, Raphael van Tulder, Andreas Zajicek, Angelika Buchinger, Christoph Testori
BACKGROUND: While prognostic values on survival after out-of-hospital cardiac arrest have been well investigated, less attention has been paid to their age-specific relevance. Therefore, we aimed to identify suitable age-specific early prognostication in elderly patients suffering out-of-hospital cardiac arrest in order to reduce the burden of unnecessary treatment and harm. METHODS: In a prospective population-based observational trial on individuals suffering out-of-hospital cardiac arrest, a total of 2223 patients receiving resuscitation attempts by the local emergency medical service in Vienna, Austria, were enrolled...
September 26, 2016: European Heart Journal. Acute Cardiovascular Care
Michael J Daly, Dewar D Finlay, Daniel Guldenring, Raymond R Bond, Aaron J McCann, Peter J Scott, Jennifer A Adgey, Mark T Harbinson
INTRODUCTION: Epicardial potentials (EPs) derived from the body surface potential map (BSPM) improve acute myocardial infarction (AMI) diagnosis. In this study, we compared EPs derived from the 80-lead BSPM using a standard thoracic volume conductor model (TVCM) with those derived using a patient-specific torso model (PSTM) based on body mass index (BMI). METHODS: Consecutive patients presenting to both the emergency department and pre-hospital coronary care unit between August 2009 and August 2011 with acute ischaemic-type chest pain at rest were enrolled...
September 26, 2016: European Heart Journal. Acute Cardiovascular Care
Uwe Zeymer, Karl Werdan, Gerhard Schuler, Ralf Zahn, Franz-Josef Neumann, Georg Fürnau, Suzanne de Waha, Steffen Schneider, Holger Thiele
BACKGROUND: Current guidelines recommend immediate multivessel percutaneous coronary intervention (PCI) in patients with cardiogenic shock, despite the lack of randomised trials. We sought to investigate the use and impact on outcome of multivessel PCI in comparison to culprit lesion only PCI in a retrospective analysis in patients with cardiogenic shock complicating acute myocardial infarction. METHODS AND RESULTS: In the randomised IABP-SHOCK II trial, investigating the effect of intra-aortic balloon pump on outcome, 451 (75%) of the total of 600 patients had multivessel coronary artery disease and underwent PCI...
September 21, 2016: European Heart Journal. Acute Cardiovascular Care
Thorarinn A Bjarnason, Linda B Kristinsdottir, Erna S Oskarsdottir, Steinar O Hafthorsson, Isleifur Olafsson, Sigrun H Lund, Karl Andersen
BACKGROUND: Previously undetected dysglycaemia is common among patients with acute coronary syndromes (ACSs). The aim of this study was to identify the most reliable method of diagnosing type 2 diabetes mellitus (T2DM) and prediabetes in ACS patients. METHODS: Patients admitted to the coronary care unit with ACSs and no previous history of T2DM were consecutively included in the study. Glucose metabolism was measured by glycated haemoglobin (HbA1c), fasting plasma glucose (FPG) and 2-hour plasma glucose (2hPG) with a standard oral glucose tolerance test during hospital admission, and this process was repeated 3 months later...
September 13, 2016: European Heart Journal. Acute Cardiovascular Care
Nadia Bouabdallaoui, Guillaume Lebreton, Pierre Demondion, Ahmed Charfeddine, Pascal Leprince
BACKGROUND: Left ventricular assist devices are valuable options for mechanical circulatory support in patients with severe heart failure as a bridge to cardiac transplantation, to recovery, or as destination therapy. Transoesophageal echocardiography plays a key role in the management of left ventricular assist device patients; either in guiding the device implantation or in post-operative haemodynamic assessment. The aim of this observational study is to investigate the usefulness of a miniaturized transoesophageal echocardiography probe designed for continuous haemodynamic monitoring (haemodynamic transoesophageal echocardiography; ImaCor, Garden City, NY) in the haemodynamic assessment of patients undergoing left ventricular assist device implantation...
December 2016: European Heart Journal. Acute Cardiovascular Care
Philipp Bahrmann, Michael Christ, Benjamin Hofner, Anke Bahrmann, Stefan Achenbach, Cornel Christian Sieber, Thomas Bertsch
BACKGROUND: Risk stratification of elderly patients presenting with heart failure (HF) to an emergency department (ED) is an unmet challenge. We prospectively investigated the prognostic performance of different biomarkers in unselected older patients in the ED. METHODS: We consecutively enrolled 302 non-surgical patients ⩾70 years presenting to the ED with a wide range of cardiovascular and non-cardiovascular comorbid conditions. N-terminal pro-B-type natriuretic peptide (NT-proBNP), mid-regional pro-adrenomedullin (MR-proADM), mid-regional pro-atrial natriuretic peptide (MR-proANP), C-terminal pro-endothelin-1 (CT-proET-1), ultrasensitive C-terminal pro-arginine-vasopressin (Copeptin-us) and high-sensitivity cardiac troponin T (hs-cTnT) were measured at admission...
December 2016: European Heart Journal. Acute Cardiovascular Care
Hans-Josef Feistritzer, Sebastian J Reinstadler, Gert Klug, Christian Kremser, Andrea Rederlechner, Johannes Mair, Silvana Müller, Wolfgang-Michael Franz, Bernhard Metzler
BACKGROUND: Aortic stiffness is associated with increased left ventricular (LV) afterload, a process which is accompanied by a release of natriuretic peptides. Aortic pulse wave velocity (PWV) has been demonstrated to be the functional surrogate of aortic stiffness. We sought to investigate the impact of aortic PWV on N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentrations in patients with acute myocardial infarction (AMI). METHODS: This prospective observational study included 86 consecutive patients undergoing percutaneous coronary intervention for AMI...
December 2016: European Heart Journal. Acute Cardiovascular Care
Rasmus Rørth, Emil L Fosbøl, Ulrik M Mogensen, Kasper Iversen, Martin Iversen, Henning Kelbæk, Frants Pedersen, Thomas Engstrøm, Christian Torp-Pedersen, Gunnar Gislason, Lars Køber
PURPOSE: β2-Agonists are widely used for relief of respiratory symptoms. Studies so far have reported conflicting results regarding use of β2-agonists and risk of myocardial infarction (MI). Yet, coronary angiographical data and longitudinal outcomes data are sparse and could help explain if there is an association between use of β2-agonists and MI. METHODS: Using a novel data-linkage of the Eastern Danish Heart Registry and nationwide administrative registries we identified a cohort of patients referred for acute coronary angiography due to ST-elevation MI (STEMI)...
December 2016: European Heart Journal. Acute Cardiovascular Care
Hesham R Omar
INTRODUCTION: Electrocardiographic (ECG) abnormalities are seen in 70%-80% of patients with acute pulmonary embolism (APE). Rarely, APE presents with ST-segment elevation (STE) in leads V1-V4, mimicking ST-segment elevation myocardial infarction (STEMI). Herein, we describe a case of APE presenting with STE in V1-V3, along with a comprehensive review of the literature. METHODS: We reviewed Pubmed/Medline indexed articles from 1950 to 2014 reporting cases of APE presenting with STE in V1-V3 or V4 (V1-V3/V4)...
December 2016: European Heart Journal. Acute Cardiovascular Care
Alberto Palazzuoli, Carlo Lombardi, Gaetano Ruocco, Margherita Padeletti, Ranuccio Nuti, Marco Metra, Claudio Ronco
Nearly a third of patients with acute heart failure experience concomitant renal dysfunction. This condition is often associated with increased costs of care, length of hospitalisation and high mortality. Although the clinical impact of chronic kidney disease (CKD) has been well established, the exact clinical significance of worsening renal function (WRF) during the acute and post-hospitalisation phases is not completely understood. Therefore, it is still unclear which of the common laboratory markers are able to identify WRF at an early stage...
December 2016: European Heart Journal. Acute Cardiovascular Care
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